Homeless Women and Their Fight for Access to Reproductive Healthcare

With the economy continuing to struggle and many facing home foreclosures due to the enormity of their interest rates and/or unemployment, homelessness continues to be an ever-manifesting problem in the United States. The homeless face a litany of obstacles that block their way towards the betterment of their situation; none of which is more debilitating than their access to healthcare. Being subject to the harshness of the outside world for most of the day and some nights does not allow a person to keep themselves as healthy as they would like. The homeless are more immune-compromised due to poor nutrition and have increased morbidity than those of the general population1. The homeless are also subject to more violence than the non-homeless which greatly increases their need for access to healthcare2.

Sadly, women and families, make up the fastest growing segment of the homeless population. As the homeless struggle with their access to medical attention and the number of homeless women (young and old) increase, a growing concern for sexual and reproductive health of these women begins to loom large. Whether residing in a temporary shelter or in a park on a bench, homeless women are very susceptible to sexual assault by other homeless people or even shelter caretakers. These rapes can result in the women needing treatment for their injuries, medication to treat or prevent an STI incurred from the attack, or, in some cases, more long-term treatment for a pregnancy that results from such an attack. How are the needs of the homeless women that get attacked in this fashion addressed? How do they get the reproductive health care that they need to help them manage the harsh extremes that they are exposed to?

The Committee on Health Care for Underserved Women, which is part of the American College of Obstetricians and Gynecologists, has taken on the issue of homelessness to heart and has encouraged physicians to reach out to patients in their practice that are, or might be in danger of becoming, homeless. This ACOG Committee encourages other organizations to donate pharmaceuticals and other resources to homeless shelters and also coordinates efforts to improve community programs and health care services that are offered to women that may be homeless. Without the efforts spearheaded by members of this committee, homeless women would scarily have far fewer options than they have today. Yet, they still face bleak conditions when attempting to pursue treatment.

Without a universal health care plan, the health needs of homeless women are not completely covered and not enough physicians are available as volunteers in the homeless clinics to provide the medical care for free. Those women that do not receive sufficient health screenings are at a greater risk for complications from STIs or unintended pregnancies. Healthcare must compete with the needs of food, clothing, and shelter in the life of a homeless woman. With an always struggling position in the balance of importance in the lives of homeless women, healthcare often gets written of and replaced with a more pressing need. Couple that with the lack of interest in physicians caring for the homeless in their offices, it becomes clear how hard it is for a homeless woman to get access to the health care that she needs.

If a homeless woman becomes the victim of a rape and is left unintentionally pregnant, her options are slim. If she does not receive treatment for the attack out of embarrassment for her situation or inability to get to a healthcare facility due to her poverty, she may not know for weeks that she is pregnant. Limited prenatal care is another on the long list of the inaccessible parts of healthcare for the homeless woman. This will result in a tougher pregnancy and a slimmer chance that her baby will make it to term.

The struggle for healthcare access in homeless women that can easily find themselves in similar situations is ongoing. Better action is needed in this area as more and more Americans face the grim possibility of homelessness. If a plan can be developed to provide care equally to all people of the United States regardless of economic situation, homeless women may one day be able to get the care that they desperately need.